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van Hoorn ES, Bassant NY, Lingsma HF, de Vries-Sluijs TE. Patient experiences with value-based healthcare interventions at the HIV outpatient clinic of the Erasmus Medical Centre. PLoS One 2024; 19:e0304859. [PMID: 38829875 PMCID: PMC11146710 DOI: 10.1371/journal.pone.0304859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/20/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND One of the aims of value-based healthcare (VBHC) is to deliver more patient-centred care. However, little is known about the effect of VBHC interventions on patient experiences. We aim to explore how patients experience VBHC as implemented in an HIV outpatient clinic in an academic hospital in the Netherlands. METHODS The HIV outpatient clinic of the Erasmus MC, Rotterdam, the Netherlands, an academic tertiary hospital, implemented a VBHC intervention consisting of 1) implementation of a generic quality of life questionnaire, administered before each visit, 2) a change in consultation schedule; from twice a year face-to-face to one face-to-face double consultation and one remote consultation per year, and 3) a change in consultation structure; from a single face-to-face consultation with the infectious diseases (ID) specialist to a double consultation in which the patient visits both the nurse and the ID specialist. Semi-structured interviews were held with Dutch or English-speaking adult patients, that had been a patient within Erasmus MC for more than 5 years, on their experiences with the implemented changes. RESULTS Thirty patients were interviewed. Patients had no objections towards completing the questionnaires especially if it could provide the professionals with additional information. Patients were primarily positive about the change in consultation schedule. For the yearly remote consultation they preferred a telephone-consultation above a video-consultation. The change in consultation structure ensured that more topics, including psychosocial and medical aspects could be discussed. Some patients did not see the added value of talking to two professionals on the same day or completing the quality of life questionnaire before their consultation. CONCLUSION Patients are generally positive towards the VBHC interventions implemented at the HIV outpatient clinic. Our findings may inform further optimization of VBHC interventions and improve patient-centred care in outpatient HIV clinics.
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Affiliation(s)
- Evelien S. van Hoorn
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Nadine Y. Bassant
- Department of Internal Medicine–Infectious Diseases, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Hester F. Lingsma
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Theodora E. de Vries-Sluijs
- Department of Internal Medicine–Infectious Diseases, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Santos MS, Santos-Lins LS, Amaral SVBAN, Brites C, Lins-Kusterer L. Temporomandibular disorders in patients with HIV: a cross-sectional study. Braz J Infect Dis 2024; 28:103769. [PMID: 38852613 PMCID: PMC11225009 DOI: 10.1016/j.bjid.2024.103769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/26/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024] Open
Abstract
Untreated HIV infection leads to severe immunodeficiency and can be associated with an accelerated aging process and a higher prevalence of frailty. Systemic changes are known to cause greater oral manifestations and decreased orofacial function. However, there is no investigation on Temporomandibular Disorders (TMD) in this population. This study aims to assess the prevalence of TMD in individuals living with HIV/AIDS. This cross-sectional study included HIV patients, with undetectable plasma viral load, under follow-up in the infectious disease's outpatient clinic at the Federal University of Bahia hospital. We recorded socio-demographic data, Fried's frailty criteria, Research Diagnostic Criteria for Temporomandibular Disorder, and Beck's Depression Inventory (BDI) through the application of structured questionnaires and extra-oral examination findings. Data analysis was conducted on SPSS-v18. The sample consisted of 198 patients. The prevalence of TMD was (33.8 %), most affecting females (46.6 %). Difficulty in opening the mouth and parafunctional habits were the main symptoms of the disease, as well as functional limitations. The mean of the BDI score was higher in TMD group than in those without TMD (11.01 ± 8.61 vs. 7.60 ± 7.52 valor de p = 0.004). Logistic regression showed an association between sex (OR=2.305, 95 % CI 1.243‒4.275) and depression (OR = 1.045, 95 % CI 1.005‒1.087) and TMD in HIV patients. The present study observed the prevalence of symptoms associated with TMD as difficulty opening the mouth, muscle fatigue, and joint noises in patients with chronic HIV and associated with depression. Highlights the importance of a broader view of the health of individuals living with HIV.
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Affiliation(s)
- Monah Sampaio Santos
- Faculdade de Medicina da Universidade Federal da Bahia (FMB-UFBA), Programa de Pós-Graduação em Medicina e Saúde, Salvador, BA, Brazil
| | - Larissa Souza Santos-Lins
- Faculdade de Medicina da Universidade Federal da Bahia (FMB-UFBA), Programa de Pós-Graduação em Medicina e Saúde, Salvador, BA, Brazil
| | | | - Carlos Brites
- Faculdade de Medicina da Universidade Federal da Bahia (FMB-UFBA), Programa de Pós-Graduação em Medicina e Saúde, Salvador, BA, Brazil
| | - Liliane Lins-Kusterer
- Faculdade de Medicina da Universidade Federal da Bahia (FMB-UFBA), Programa de Pós-Graduação em Medicina e Saúde, Salvador, BA, Brazil.
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Perazzo H, Gonçalves JL, Cardoso SW, Grinsztejn B, Veloso VG, Luz PM. Pathways to Poor Adherence to Antiretroviral Therapy Among People Living with HIV: The Role of Food Insecurity and Alcohol Misuse. AIDS Behav 2024; 28:1173-1185. [PMID: 37523050 DOI: 10.1007/s10461-023-04141-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/01/2023]
Abstract
Daily adherence to antiretroviral therapy (ART) increases the length and quality of life of people living with HIV (PLHIV). We explored whether socioeconomic status directly impacts ART adherence and whether part of the effect is mediated by pathways through alcohol misuse or food insecurity. A cross-sectional study was conducted in Rio de Janeiro/Brazil (November/2019 to March/2020) with PLHIV aged ≥ 18 years. Validated instruments were used to measure alcohol use, food insecurity, and ART adherence. Using structural equation modeling we assessed the direct and indirect effects of variables on ART adherence. Participants reported significant challenges: hunger: 12%, alcohol use: 64%, and missing ART doses: 24%. Results showed that lower socioeconomic status increased poor adherence and that this effect was mediated through higher food insecurity. Alcohol misuse also increased poor adherence through a strong direct effect. Providing socio-economic support coupled with interventions to mitigate alcohol's harmful impact can aid HIV care.
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Affiliation(s)
- Hugo Perazzo
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
| | - Juliana L Gonçalves
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
| | - Sandra W Cardoso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
| | - Valdilea G Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
| | - Paula M Luz
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil.
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de Oliveira Gomes M, Castro R, Corrêa da Mota J, De Boni RB. Association of syndemic conditions and quality of life among people living with HIV/AIDS. AIDS Care 2023; 35:1508-1517. [PMID: 35621316 DOI: 10.1080/09540121.2022.2080801] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
The syndemics theory seeks to understand the effect of multiple synergic problems in promoting poor health outcomes. To disentangle which and how syndemic conditions affect the quality of life (QoL) may be important to improve well-being of people living with HIV/AIDS (PLWHA). This study evaluates the association between syndemic conditions and QoL among PLWHA. We performed a secondary analysis using data obtained between 2014 and 2017 among PLWHA under care in Rio de Janeiro, Brazil. The outcomes were the six QoL domains (physical, psychological, level of independence, social relationships, environmental, and spirituality) measured through the World Health Organization Quality of Life in HIV infection scale, abbreviated version (WHOQOL-HIV-BREF). The independent variables were demographic and clinical characteristics, syndemic conditions (binge drinking, compulsive sexual behavior, polysubstance use, intimate partner violence, and depression), and syndemics (two or more syndemic conditions simultaneously). Bivariate analysis (t-test and ANOVA) and linear regressions were performed for each quality-of-life domain. The analytical sample comprised 1530 participants, mostly male at birth (64%) and with median age of 43 years. The syndemic conditions most frequently observed were binge drinking (56%), IPV (13%), and depression (9%). Both individual syndemic conditions and syndemics were associated with worse QoL. In the multivariate analysis, positive screening for depression was associated with worse QoL in all domains. Polysubstance users presented worse QoL at social and environmental domains. Intimate partner violence was associated with worse QoL at environment domain while binge drinking was associated with worse scores in the physical domain. The presence of syndemics increased the likelihood of worse scores in the psychological, social, and environment domains. Our study expands the understanding of QoL in PLWHA, as it considers a holistic/integral, multifactorial, and synergistic approach to the determinants of QoL. Seeking strategies that target syndemics may be important to improve patient-centered outcomes in health.Abbreviations: HIV/AIDS: human immunodeficiency virus/acquired immunodeficiency syndromeWHO: World Health OrganizationQoL: quality of lifeHRQoL: health-related quality of lifePLWHA: people living with HIV/AIDScART: combined antiretroviral therapyIPV: intimate partner violenceINI/FIOCRUZ: Evandro Chagas National Institute of Infectious DiseasesOswaldo Cruz FoundationSRH: self-rated healthVL: viral loadCD4: CD4 cell countNIAAA: National Institute on Alcohol Abuse and AlcoholismCSBcompulsive sexual behaviorWHO-ASSIST: alcoholsmoking and substance involvement screening test developed by the World Health OrganizationPHQ-2: Patient Health Questionnaire-2.
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Affiliation(s)
| | - Rodolfo Castro
- Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
- Evandro Chagas National Institute of Infectious Diseases/Oswaldo Cruzs Foundation, Rio de Janeiro, Brazil
- Sergio Arouca National School of Public Health/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Jurema Corrêa da Mota
- Institute of Technological Communication and Information in Health, Laboratory of Health Information/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Raquel B De Boni
- Evandro Chagas National Institute of Infectious Diseases/Oswaldo Cruzs Foundation, Rio de Janeiro, Brazil
- Institute of Technological Communication and Information in Health, Laboratory of Health Information/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Delle Donne V, Massaroni V, Borghetti A, Ciccullo A, Dusina A, Lombardi F, Steiner RJ, Iannone V, Salvo PF, Di Giambenedetto S. Characteristics of mental health interventions in a cohort of Italian PLWH over the last five years: impact of HIV disease and outbreak of COVID-19 pandemic. PSYCHOL HEALTH MED 2023; 28:2562-2578. [PMID: 37287347 DOI: 10.1080/13548506.2023.2221447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
Evidence accumulated during past years confirm that people living with HIV (PLWH) still have to deal with comorbidities and chronic complications that can increase physical and psychological issues and can affect daily functioning, quality of life and mental health. Moreover, during the COVID-19 pandemic PLWH proved to be a population at increased risk of psychological distress. We explored the ongoing issues and the characteristics of the mental health interventions for which a cohort of Italian PLWH interacted with a psychologist over the past five years. We analysed a dataset that included 61 PLWH who underwent a psychological intervention between 2018 and 2022. We compared different frequencies in characteristics of mental health interventions according to different demographic and clinical variables, psychopathological symptoms and time of the request for intervention. We showed that psychopathological symptoms most frequently reported by patients were anxiety (55.7%), and depression (49.2%). Furthermore, we reported that most our patients undertook occasional psychological support meetings (31%), sought an intervention after the outbreak of the COVID-19 pandemic (62.3%) and complained about disclosure issues (48.5%). Disclosure issues were mainly reported by younger PLWH (p = 0.002) with a shorter disease (p = 0.031) and treatment history (p = 0.032), and higher interpersonal sensitivity (p = 0.042). It seems fundamental to integrate psychological interventions into the care of PLWH, to give particular attention to PLWH with risky demographic, clinical and mental health factors and to pay special attention to emergency conditions (such as the COVID-19 pandemic) and the most widespread issues to create ad hoc interventions.
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Affiliation(s)
- Valentina Delle Donne
- Infectious Diseases Institute, Department of Safety and Bioethics, Catholic University of Sacred Heart, Rome, Italy
| | - Valentina Massaroni
- Infectious Diseases Institute, Department of Safety and Bioethics, Catholic University of Sacred Heart, Rome, Italy
| | - Alberto Borghetti
- UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Arturo Ciccullo
- UOC Infectious Diseases, Ospedale S. Salvatore, L'Aquila, Italy
| | - Alex Dusina
- UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesca Lombardi
- UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rebecca Jo Steiner
- UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valentina Iannone
- UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Simona Di Giambenedetto
- Infectious Diseases Institute, Department of Safety and Bioethics, Catholic University of Sacred Heart, Rome, Italy
- UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Mesías-Gazmuri J, Folch C, Palacio-Vieira J, Bruguera A, Egea-Cortés L, Forero CG, Hernández J, Miró JM, Navarro J, Riera M, Peraire J, Alonso-García L, Díaz Y, Casabona J, Reyes-Urueña J. Syndemic conditions and quality of life in the PISCIS Cohort of people living with HIV in Catalonia and the Balearic Islands: a cross sectional study. Health Qual Life Outcomes 2023; 21:42. [PMID: 37165368 PMCID: PMC10173626 DOI: 10.1186/s12955-023-02120-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/24/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND People living with HIV (PLWH) face structural and psychosocial factors that affect health-related quality of life (HRQoL). We aimed to evaluate how syndemic conditions affected HRQoL in PLWH. METHODS A cross-sectional survey was conducted among 861 PLWH, to determine whether syndemic conditions (monthly income; sexual satisfaction; depressive symptoms; social role satisfaction; social isolation; cognitive function; nicotine dependence; perception of stigma) have an effect on HRQoL. A linear regression model and measures of Additive Interaction (AI) were used to determine the effects of syndemic conditions on HRQoL, controlling for other risk factors. RESULTS Overall, the most frequently observed were stigma perception (56.9%), poor cognitive function (50.6%) and the perception of social isolation (51.6%). The presence of depressive symptoms was the risk factor most associated with worse Physical Health (PH) (B 3.93, 2.71-5.15) and Mental Health (MH) (B 5.08, 3.81-6.34) in linear regression model. Specifically, an interaction was observed between poor cognitive function and poor satisfaction with social role on worse PH and MH (AI 2.08, 0.14-4.02; AI 2.69, 0.15-5.22, respectively); and low income and perception of stigma (AI 2.98, 0.26-5.71), low income and perception of social isolation (AI 2.79, 0.27-5.32), and low income and poor satisfaction with social role (AI 3.45, 0.99-5.91) on MH. CONCLUSION These findings provide evidence that syndemic factors impact HRQoL. HIV prevention programs should screen and address co-occurring health problems to improve patient-centered health care and outcomes.
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Affiliation(s)
- Jocelyn Mesías-Gazmuri
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- PhD in Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universidad Autonoma de Barcelona, Badalona, Spain
| | - Cinta Folch
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain.
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
| | - Jorge Palacio-Vieira
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Andreu Bruguera
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- PhD in Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universidad Autonoma de Barcelona, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Laia Egea-Cortés
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Carlos G Forero
- Department of Medicine. School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat, Spain
| | - Juan Hernández
- Grupo de Trabajo Sobre Tratamientos del VIH (gTt), Barcelona, Spain
| | - José M Miró
- Infectious Diseases Service. Hospital Clínic-IDIBAPS. University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Navarro
- Infectious Diseases Department. Hospital, Universitari Vall d'Hebron, Barcelona, Spain
- Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | | | - Joaquim Peraire
- Infectious Diseases Department. Hospital, Universitari Vall d'Hebron, Barcelona, Spain
- Hospital Joan XXIII, IISPV, Universitat Rovira I Virgili, Tarragona, Spain
| | - Lucía Alonso-García
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Yesika Díaz
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Jordi Casabona
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Univ Autonoma de Barcelona, Badalona, Spain
| | - Juliana Reyes-Urueña
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
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Jones MC, Byun JY, Billings R, Shorten A, Kempf MC, Vance DE, Puga F. Tools for Screening and Measuring Anxiety Among Women Living with HIV of Reproductive Age: A Scoping Review. AIDS Behav 2023:10.1007/s10461-023-03990-9. [PMID: 36757556 DOI: 10.1007/s10461-023-03990-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/10/2023]
Abstract
Emerging evidence suggests that women living with HIV (WLWH) may experience higher rates of anxiety than men living with HIV and women living without HIV. To date, relatively little knowledge exists on valid anxiety screening and diagnostic tools and how they are used among WLWH, specifically WLWH of reproductive age. Thus, the purpose of this scoping review was to describe what is known in the published literature about anxiety among WLWH and the tools used to measure and screen for anxiety in clinical and research contexts. The Arksey and O'Malley methodological framework was used to guide a scoping review of published articles in PsycINFO, Scopus, Sociological Abstracts, and PubMed databases. Twenty-one measures of anxiety were used across the 52 articles identified in the search. Most measures used were self-report. Inconsistencies in standardized screening tools and cutoff scores were observed across studies. Further, measures to assess anxiety varied among studies focused on WLWH. Based on the results from this review, there is a need for consistent, valid measures of anxiety to advance research and clinical practice to support the well-being of WLWH.
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Affiliation(s)
- Meghan C Jones
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA.
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Shorten
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Mirjam-Colette Kempf
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
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Madundo K, Knettel BA, Knippler E, Mbwambo J. Prevalence, severity, and associated factors of depression in newly diagnosed people living with HIV in Kilimanjaro, Tanzania: a cross-sectional study. BMC Psychiatry 2023; 23:83. [PMID: 36726113 PMCID: PMC9890688 DOI: 10.1186/s12888-022-04496-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/23/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Depression is particularly common among people living with Human Immunodeficiency Virus (HIV), with some studies showing a prevalence of depression three times higher among people living with HIV as compared to the general public. The stress associated with being diagnosed with HIV can be quite impactful, including concerns about one's long-term health, stigma, and the burden of long-term treatment. Therefore, it is common for a new HIV diagnosis to contribute to the onset of depressive symptoms. The objective of this study was to determine the prevalence and severity of depression, and its associated factors in people diagnosed with HIV within the past 12 months. METHODS We conducted a cross-sectional survey with patients newly diagnosed with HIV at three hospitals in the Kilimanjaro region of Tanzania utilizing a locally validated version of the Patient Health Questionnaire-9 (PHQ-9) as a screener for depression, the Demographic Health Survey (SES-DHS8) for socio-demographic characteristics, and the Duke-UNC Functional Social Support Questionnaire (FSSQ) to assess perceived social support. We enrolled 272 participants between September and December 2020, diagnosed with HIV within the past 12 months. Analysis of Co-variance (ANCOVA) and Bonferroni post-hoc analysis were used to determine associations of sociodemographic variables with the dependent variable of depression. RESULTS Overall prevalence of depression in our sample was 41%, including 54 participants (20%) with moderate symptoms, 42 (15%) with moderately severe symptoms, and 16 (6%) with severe symptoms. Severity was highest in participants diagnosed with HIV less than 1 month ago. An ANCOVA model (overall F = 4.72, p < 0.001) assessing factors associated with greater depression severity revealed significant effects of study site (F = 7.6, p < 0.001), female gender (F = 5.11, p = 0.02), and less time since HIV diagnosis (F = 12.3, p < 0.001). CONCLUSION The study demonstrates very high prevalence of depression among people living with HIV in this setting, particularly among those newly diagnosed, female participants, and those seen at the larger regional referral hospital. Integration of mental health screening and interventions into CTC care is vital in the first visits following a positive test result and may be tailored to meet the needs of patients at highest risk for developing symptoms of depression.
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Affiliation(s)
- Kim Madundo
- Department of Mental Health and Psychiatry, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
| | - Brandon A Knettel
- Duke University School of Nursing and Duke Global Health Institute, Durham, NC, USA
| | - Elizabeth Knippler
- Duke Centre for AIDS Research, Duke University School of Nursing, Durham, NC, USA
| | - Jessie Mbwambo
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Han S, Zhang Y, Yang X, Li K, Zhang L, Shao Y, Ma J, Hu Y, Zhu Z, Zhang Y, Wang Z. Exploring core mental health symptoms among persons living with HIV: A network analysis. Front Psychiatry 2023; 14:1081867. [PMID: 36741117 PMCID: PMC9895861 DOI: 10.3389/fpsyt.2023.1081867] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
CONTEXT Persons living with HIV (PLWH) commonly experience mental health symptoms. However, little is known about the core mental health symptoms and their relationships. OBJECTIVE This study aimed to evaluate the prevalence of various mental health symptoms and to explore their relationships in symptom networks among PLWH. METHODS From April to July 2022, we recruited 518 participants through convenience sampling in Beijing, China, for this cross-sectional study. Forty mental health symptoms, including six dimensions (somatization symptoms, negative affect, cognitive function, interpersonal communication, cognitive processes, and social adaptation), were assessed through paper-based or online questionnaires. Network analysis was performed in Python 3.6.0 to explore the core mental health symptoms and describe the relationships among symptoms and clusters. RESULTS Of the 40 mental health symptoms, the most common symptoms were fatigue (71.2%), trouble remembering things (65.6%), and uncertainty about the future (64.0%). In the single symptom network, sadness was the most central symptom across the three centrality indices (rS = 0.59, rC = 0.61, rB = 0.06), followed by feeling discouraged about the future (rS = 0.51, rC = 0.57, rB = 0.04) and feelings of worthlessness (rS = 0.54, rC = 0.53, rB = 0.05). In the symptom cluster network, negative affect was the most central symptom cluster across the three centrality indices (rS = 1, rC = 1, rB = 0.43). CONCLUSION Our study provides a new perspective on the role of each mental health symptom among PLWH. To alleviate the mental health symptoms of PLWH to the greatest extent possible and comprehensively improve their mental health, we suggest that psychological professionals pay more attention to pessimistic mood and cognitive processes in PLWH. Interventions that apply positive psychology skills and cognitive behavioral therapy may be necessary components for the mental health care of PLWH.
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Affiliation(s)
- Shuyu Han
- School of Nursing, Peking University, Beijing, China
| | - Yizhu Zhang
- School of Nursing, Peking University, Beijing, China
| | - Xianxia Yang
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Ke Li
- Department of Emergency, Peking University First Hospital, Beijing, China
| | - Lili Zhang
- Department of Nursing, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, China
| | - Ying Shao
- Department of Infection, Beijing Youan Hospital Affiliated With Capital Medical University, Beijing, China
| | - Jianhong Ma
- Department of Infection, Beijing Youan Hospital Affiliated With Capital Medical University, Beijing, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China
| | - Yukun Zhang
- School of Nursing, Fudan University, Shanghai, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China
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Age and Mental Health Symptoms Among Chinese Persons With HIV: The Mediating and Moderating Role of Perceived Discrimination. J Assoc Nurses AIDS Care 2023; 34:105-112. [PMID: 36656094 DOI: 10.1097/jnc.0000000000000373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
ABSTRACT The association between age and mental health symptoms among persons with HIV (PWH) is inconsistent, and little is known about the mediators and moderators of this association. This study aimed to examine the association between age and mental health symptoms, as well as the mediators and moderators of perceived discrimination. Data were from 1,304 PWH who completed a cross-sectional survey in five areas of China. Multiple linear regressions showed that younger age was significantly associated with more severe mental health symptoms and that perceived discrimination moderated this relationship. The Sobel test showed that perceived discrimination also mediated the association between age and mental health symptoms. Our study indicates that perceived discrimination shapes the association between age and mental health symptoms among PWH and highlights the importance of designing age-tailored mental health intervention strategies for perceived discrimination among young PWH. Interventions addressing discrimination are necessary to help improve mental health, especially for young PWH.
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11
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de Pinho CSN, Santana RD, Campos EDM, Pires Neto RDJ. Prevalence and factors associated with depression in people living with HIV/AIDS in a Brazilian metropolitan region. AIDS Care 2022; 34:1580-1585. [PMID: 35862689 DOI: 10.1080/09540121.2022.2100866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The frequent association between mental disorders and HIV infection may be related to several risk factors. The present study aims to determine the prevalence of depression and its associated factors in people living with HIV/AIDS (PLWHA) who attended four outpatient clinics in Fortaleza, Brazil, between September 2014 and April 2015. In addition to the Mini International Neuropsychiatric Interview questionnaire, which was used to identify the prevalence of depressive disorder, the researchers applied a sociodemographic questionnaire, and the Hamilton Depression Scale to classify the severity of depression. In all, 257 participants were included in the analyses. The overall lifetime prevalence of depression was identified to be 29.2% (19.5% in men and 44.9% in women). The prevalence of a current depressive episode was 18.7%. Mild, moderate, and severe depression was identified in 2.1%, 12.5%, and 85.4%, respectively. The factors related to depression were: gender, marital status, income, educational level, current employment status, and family history of depression. This study highlights the importance of lifetime depression as a disorder of high prevalence in PLWHA, and associated with risk factors that are difficult or impossible to be modified. Early diagnosis and treatment of depression may improve quality of life in PLWHA.
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Affiliation(s)
- Carolina Saraiva Nunes de Pinho
- Public Health Post-Graduation Program, School of Medicine, Federal University of Ceará, Fortaleza, Brazil.,São José Hospital of Infectious Diseases, Fortaleza, Brasil
| | - Rafael Dantas Santana
- Division of Psychiatry, Walter Cantídio University Hospital, Federal University of Ceará, Fortaleza, Brasil
| | - Eugênio de Moura Campos
- Division of Psychiatry, Walter Cantídio University Hospital, Federal University of Ceará, Fortaleza, Brasil.,Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Roberto da Justa Pires Neto
- Public Health Post-Graduation Program, School of Medicine, Federal University of Ceará, Fortaleza, Brazil.,São José Hospital of Infectious Diseases, Fortaleza, Brasil.,Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
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12
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Xing HY, Yan J. Quality of Life Assessment and Related Factors of HIV-Infected Patients in Hangzhou Using a Path Analysis Model: An Observational Study. Int J Gen Med 2022; 15:6325-6333. [PMID: 35924180 PMCID: PMC9342877 DOI: 10.2147/ijgm.s373796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/21/2022] [Indexed: 12/01/2022] Open
Abstract
Objective This study aimed to examine which path among direct and indirect effects was more influential to the quality of life (QOL) for patients with human immunodeficiency virus (HIV). Methods An observational study among 951 individuals diagnosed with HIV was conducted in designated acquired immunodeficiency syndrome (AIDS) medical institutions in Hangzhou using simple random sampling technique. We collected the demographic data of patients and then evaluated their QOL by 12-Item Short-Form (SF-12) questionnaire survey. The two-stage least squares analysis was firstly performed to filter the independent influencing factors of Physical Component Summary (PCS) and Mental Component Summary (MCS). We then enrolled the PCS, MCS, and their influencing factors into the path analysis of QOL, and further revealed the direct and indirect effects of variables and examined the important path that was more influential on the patient’s QOL. Results The patient’s PCS, MCS, and quality of life showed a significant difference between groups in terms of education level and working condition (all P<0.05). Regression analysis showed that depression, age, education level, and treatment independently affected the PCS (all P<0.05), and depression and anxiety exerted an independent effect on the MCS (all P<0.05). Further path analysis integrating related variables showed that the main indexes of the goodness of fit implied the final model fit the data well. The path analysis showed that PCS and MCS exerted direct effects on the QOL (all P<0.001), especially the MCS (β=0.785), but other variables exerted no direct effects (all β=0, all P>0.05). It should be noted that anxiety presented an obvious indirect effect on the QOL (β=0.460), and its indirect effect was similar to the direct effect of PCS (β=0.471). Conclusion The MCS might exert a more important effect on the QOL of HIV patients. In addition, the indirect effect of anxiety on the QOL should not be ignored.
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Affiliation(s)
- Hao-yu Xing
- Medical Engineering Department, Hangzhou Seventh People’s Hospital, Hangzhou, 310013, People’s Republic of China
| | - Juan Yan
- Medical Affairs Department, Hangzhou Seventh People’s Hospital, Hangzhou, 310013, People’s Republic of China
- Correspondence: Juan Yan, Medical Affairs Department, Hangzhou Seventh People’s Hospital, No. 305, Tianmushan Road, Xihu District, Hangzhou, 310013, People’s Republic of China, Email
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Narváez M, Lins-Kusterer L, Valdelamar-Jiménez J, Brites C. Quality of Life and Antiretroviral Therapy Adherence: A Cross-Sectional Study in Colombia. AIDS Res Hum Retroviruses 2022; 38:660-669. [PMID: 35459414 DOI: 10.1089/aid.2021.0233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The introduction of highly active combined antiretroviral therapy (cART) has changed the management of HIV/AIDS, which is recognized as a chronic disease with relevant aspects, such as adherence and quality of life. This study aimed to compare clinical and demographic characteristics and health-related quality of life in people with adherence and non-adherence to cART. A cross-sectional study was carried out with 200 participants. The instruments used were the Adherence Follow-up Questionnaire, the Beck Depression Inventory-II, the 36-Item Short Form Health Survey and the WHOQOL-HIV BREF. Poisson regression was applied to obtain estimates of adjusted prevalence ratios (PRadj). Individuals lacking therapeutic support were more likely to be non-adherent than those with proper support (PR: 1.79). The health-related quality of life of individuals with non-adherence was 4% lower (PR = 0.96) in the general health domain than individuals with adherence. Non-adherence to cART was associated with lower quality of life in the general health domain and no therapeutic support.
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Affiliation(s)
- Mónica Narváez
- Post Graduation Program in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, Brazil
- Research Laboratory in Infectious Diseases (LAPI), University Hospital Complex Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Liliane Lins-Kusterer
- Post Graduation Program in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, Brazil
- Research Laboratory in Infectious Diseases (LAPI), University Hospital Complex Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Juliet Valdelamar-Jiménez
- Post Graduation Program in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, Brazil
- Research Laboratory in Infectious Diseases (LAPI), University Hospital Complex Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Carlos Brites
- Post Graduation Program in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, Brazil
- Research Laboratory in Infectious Diseases (LAPI), University Hospital Complex Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
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14
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Mohamad Fisal ZA, Minhat HS, Mohd Zulkefli NA, Ahmad N. Biopsychosocial approach to understanding determinants of depression among men who have sex with men living with HIV: A systematic review. PLoS One 2022; 17:e0264636. [PMID: 35286312 PMCID: PMC8920233 DOI: 10.1371/journal.pone.0264636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 02/14/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Men who have sex with men (MSM) living with HIV are more likely to be depressed than MSM without HIV. The AIDS epidemic will not end if the needs of people living with HIV and the determinants of health are not being addressed. Compared to HIV individuals without depression, depressed HIV individuals have worse clinical outcomes and higher mortality risk. Depression is caused by a complex combination of social, psychological, and biological variables. This systematic review, thereby motivated by the need to address this gap in the literature, aims to articulate determinants of depression among MSM living with HIV according to the biopsychosocial approach. METHODOLOGY We systematically searched four databases from 2011 to 2021. We searched for observational studies on determinants of depression among MSM living with HIV. The outcome is depression based on the categorical or numerical outcome. Two reviewers independently extracted data and assessed study risks of bias. Any disagreements are consulted with the third reviewer. RESULTS We identified 533 articles, of which only eight studies are included. A total of 3,172 MSMs are included in the studies. We found the determinants of depression and categorized them according to biological, psychological, and social approaches. CONCLUSION The determinants of depression with the strongest evidence across studies were enacted HIV-related stigma, unemployment, sleep disturbance, current smoker, black ethnicity, born overseas, ART initiation, and access to mental health care. Despite weaker evidence, the other relevant determinants to be included were older age, internalized stigma, self-efficacy, and social support. Efforts to improve or prevent depression among MSM living with HIV could benefit from addressing the determinants of depression based on the biopsychosocial approach immediately after HIV diagnosis. Integrating mental health screening and care into HIV treatment settings would strengthen HIV prevention and care outcomes and improve access to mental healthcare.
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Affiliation(s)
- Zul Aizat Mohamad Fisal
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- * E-mail:
| | - Halimatus Sakdiah Minhat
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nor Afiah Mohd Zulkefli
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Norliza Ahmad
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Mabusela M, Tomita A, Paruk S, Paruk F. Prevalence of depressive symptoms in patients with rheumatoid arthritis at a regional hospital in KwaZulu-Natal, South Africa. S Afr J Psychiatr 2022; 28:1702. [PMID: 35281960 PMCID: PMC8905454 DOI: 10.4102/sajpsychiatry.v28i0.1702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 08/06/2021] [Indexed: 12/04/2022] Open
Abstract
Background Depression affects 14.8% – 38.8% of patients with rheumatoid arthritis (RA) in developed countries. The prevalence and risk factors for depression in patients with RA in sub-Saharan Africa is not well established. Aim To determine the prevalence of depressive symptoms in patients with RA. Setting Public sector regional hospital in South Africa. Methods A cross-sectional descriptive study was undertaken with 110 adult RA patients. A structured socio-demographic and clinical questionnaire, the modified health assessment questionnaire (mHAQ), the simplified disease activity index (SDAI) for RA, the patient health questionnaire (PHQ-9), and the Household Food Insecurity Access scale (HFIAS) for nutritional status, were used. Correlates of depressive symptomatology in participants with RA were identified using t-tests and regression analyses. Results Most of the participants were women (90.9%), 67% had moderate to severe RA disease on the SDAI score, 92.7% reported functional disability (HAQ score of ≥ 1), and 87.2% reported mild to severe depressive symptoms. Unemployment (p < 0.01), severe food insecurity (p < 0.01) and functional disability (p = 0.02), were significantly associated with the depressive symptoms, but not with disease activity (p = 0.8) or inflammatory markers (p = 0.63). Unemployment (adjusted β = −5.07, p < 0.01) and severe food insecurity (adjusted β = −4.47, p < 0.01) were significantly associated with depressive symptoms, based on the adjusted regression model. Conclusion As RA effects functional status, with the impact of the resulting unemployment and food insecurity being associated with depression, affected people should be screened for depression and managed using a multidisciplinary approach, especially considering the role of social determinants in RA patients with depression.
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Affiliation(s)
- Mfundo Mabusela
- Department of Internal Medicine, Faculty of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- Department of Psychiatry, Faculty of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Farhanah Paruk
- Department of Rheumatology, Faculty of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Araujo RA, Amaral S, Tolentino A, Zeballos D, Montaño I, Souza LS, Lins-Kusterer L, Brites C. Low Quality of Life, Falls, and Pre-Frailty are Associated with Depressive Symptoms in Virologically Suppressed PLWHIV in Salvador, Brazil. AIDS Behav 2022; 26:397-406. [PMID: 34312738 DOI: 10.1007/s10461-021-03393-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2021] [Indexed: 11/25/2022]
Abstract
Depression is the leading cause of years lived with disability worldwide and PLWHIV present a higher risk of developing depressive symptoms. We aimed to evaluate depressive symptoms and their predictors in virologically suppressed PLWHIV. We conducted a cross-sectional study with 200 PLWHIV. Depressive symptoms were defined as scoring ≥ 14 points in the Beck Depression Inventory II. Most of the participants (58.5%) were men, with a median age of 54 years (IQR: 46.25-59.00). Depressive symptoms' prevalence was 19.5% and they were associated with being divorced/widowed (aOR: 2.93, CI 95%: 1.17-7.37), recurrent falls (aOR: 4.24, CI 95%: 1.07-16.85), pre-frailty (aOR: 3.55, CI 95%: 1.47-8.57), and lower scores in all HRQoL dimensions. Although virologically suppressed PLWHIV presented lower prevalence of depressive symptoms than reported in previous studies in Brazil and South America, they were associated with falls and frailty, highlighting the need for screening.
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Affiliation(s)
- Rafael Antonius Araujo
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Sávio Amaral
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil.
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil.
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil.
| | - Arthur Tolentino
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Diana Zeballos
- Programa de Pós-graduação em Saúde Coletiva (PPgSC), Universidade Federal da Bahia, Salvador, Brazil
| | - Iris Montaño
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Lucca S Souza
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Liliane Lins-Kusterer
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Carlos Brites
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
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Rahmati J, Ahmadi S, Rezaei S, Hosseinifard H, Dehnad A, Shabaninejad H, Aryankhesal A, Ghasemyani S, Alihosseini S, Mansour Kiaee Z, Noorani Mejareh Z, Aghalou S, Ghashghaee A, Shoghi M, Ahmadi Nasab M, Khajehvand A. The worldwide prevalence of anxiety in acquired immune deficiency syndrome patients: A systematic review and meta-analysis. Med J Islam Repub Iran 2021; 35:101. [PMID: 34956947 PMCID: PMC8683796 DOI: 10.47176/mjiri.35.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Indexed: 12/25/2022] Open
Abstract
Background: Anxiety affects social, economic, and physical aspects of daily life in patients with AIDS. Therefore, it is necessary to take preventive measures and design plans to maintain their general health. The present study was the first comprehensive systematic literature review research that examined the worldwide prevalence rate of anxiety in patients with AIDS.
Methods: We searched for papers published in the English language in the major databases including Embase, PubMed, Web of Science, Scopus, Cochrane, and Google Scholar from 2000 to October 2018. There were 40 studies which found to be eligible. These studies were independently evaluated and the collected data were entered in a data extraction form, which was then analyzed by two authors and a third author if necessary. Der Simonian-Laird model was used to estimate the prevalence rate on a Forest plot at the interval confidence of 95%.
Results: The total sample size was 24111, and the total number of people with anxiety was 5546. The results based on the random-effects model showed that the rate of anxiety prevalence in the patients was 25% (CI: 95%, 21% -30%) with heterogeneity of 97.9% and a significance level of p<0.001. The South America continent with a prevalence of 38% (95% CI, 34%-42%) had the highest anxiety prevalence rates and Africa with 19% (95% CI, 12% -29%) had the lowest anxiety prevalence rates.
Conclusion: Based on findings, the prevalence of anxiety in developed countries was partially higher than in underdeveloped countries and the obtained mean in the present study. It can be a significant point for policymakers. Therefore, WHO and the world community should have special plans for these countries.
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Affiliation(s)
- Jeiran Rahmati
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Saba Ahmadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Rezaei
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Hosseinifard
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Afsaneh Dehnad
- Department of Foreign Languages, School of Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hosein Shabaninejad
- Population Health Sciences Institute (PHSI), Newcastle University, Newcastle, UK
| | - Aidin Aryankhesal
- Health Management and Economics Research Centre, Iran University of Medical Sciences, Tehran, Iran.,Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam Ghasemyani
- Student Research Committee, Faculty of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Mansour Kiaee
- School of Health Management & Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Noorani Mejareh
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Aghalou
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ghashghaee
- School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mahnaz Shoghi
- Nursing care research center, Nursing and midwifery school, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ahmadi Nasab
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Anahita Khajehvand
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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18
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Ahmed A, Saqlain M, Umair MM, Hashmi FK, Saeed H, Amer M, Blebil AQ, Dujaili JA. Stigma, Social Support, Illicit Drug Use, and Other Predictors of Anxiety and Depression Among HIV/AIDS Patients in Pakistan: A Cross-Sectional Study. Front Public Health 2021; 9:745545. [PMID: 34660521 PMCID: PMC8514983 DOI: 10.3389/fpubh.2021.745545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/31/2021] [Indexed: 01/30/2023] Open
Abstract
Introduction: Anxiety and depression in people living with HIV/AIDS (PLWHA) can lead to non-adherence to antiretroviral therapy (ART), morbidity, and mortality. Therefore, assessing the stigma, social support, and other determinants of anxiety and depression in PLWHA are important for developing further interventions. Methods: An institution-based cross-sectional study was conducted in 505 PLWHA, approached through systematic sampling, who paid routine visits to the ART center, Pakistan Institute of Medical Sciences (PIMS), Islamabad. Data was collected by pretested validated hospital anxiety and depression scale (HADS). Version 26 of the SPSS was used to apply Logistic regression analysis to identify determinants, and the 95% confidence interval (CI) adjusted odds ratio (AOR) was calculated to assess the magnitude of the relationships. Results: In PLWHA, the prevalence of co-morbid depression and anxiety was 80%. Separately, 89.9% had depression, and 80.3% had anxiety. Use of illicit drugs [AOR = 1.87, 95% CI (1.01, 3.27)], low social support [AOR = 1.21, 95% CI (1.02, 2.25)], being male [AOR = 2.21, 95% CI (1.11, 5.49)], and HIV related stigma [AOR = 2.48, 95% CI (1.25, 6.02)] were significant predictors of depression. Having detectable viral load [AOR = 3.04, 95% CI (1.04, 8.86)], young age [AOR = 5.31, 95% CI (1.19, 29.39)], no formal education [AOR = 21.78, 95% CI (4.03, 117.62)], low [AOR = 1.70, 95% CI (1.12, 6.93)] or moderate [AOR = 2.20, 95% CI (1.79, 6.09)] social support, illicit drugs addiction [AOR = 1.17, 95% CI (1.03, 2.55)], and HIV stigma [AOR = 54.3, 95% CI (21.20, 139.32)] had a remarkable association with anxiety. Conclusions: Given the high prevalence of anxiety and depression among PLWHA, the Pakistan Ministry of Health should focus more on monitoring mental health, expanding mental health services, and developing interventions based on identified factors to treat depression and anxiety among PLWHA.
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Affiliation(s)
- Ali Ahmed
- School of Pharmacy, Monash University, Subang Jaya, Malaysia
| | - Muhammad Saqlain
- Department of Pharmacy, Quaid i Azam University Islamabad, Islamabad, Pakistan
| | - Malik Muhammad Umair
- National AIDs Control Program, Prime Minister Health Complex, Islamabad, Pakistan
| | - Furqan Khurshid Hashmi
- University College of Pharmacy, University of the Punjab, Allama Iqbal, Lahore, Pakistan
| | - Hamid Saeed
- University College of Pharmacy, University of the Punjab, Allama Iqbal, Lahore, Pakistan
| | - Muhammad Amer
- Department of Pharmacy, The University of Lahore, Islamabad, Pakistan
| | - Ali Qais Blebil
- School of Pharmacy, Monash University, Subang Jaya, Malaysia
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19
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Huang F, Chen WT, Lin SH, Tun MS, Nwe TW, Oo YTN, Oo HN. Translation, Adaption, and Psychometric Testing of the Myanmar Version of the Medical Outcomes Study Social Support Survey for People Living With HIV/AIDS. Front Psychol 2021; 12:707142. [PMID: 34557132 PMCID: PMC8452870 DOI: 10.3389/fpsyg.2021.707142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: Valid and reliable instruments are crucial for measuring perceived social support among people living with HIV (PLHIV). We aimed to investigate the psychometric properties of the English version of the 19-item Medical Outcomes Study Social Support Survey (MOS-SSS) adapted for PLHIV in Myanmar. Methods: Based on a standard cross-cultural procedure, we adapted the MOS-SSS and formed a Myanmar version of the scale (MOS-SSS-M), and then tested its validity and reliability. A sample of 250 eligible PLHIV was collected from a closed Facebook group that included more than 10,000 Myanmars, most of whom were PLHIV. Results: The MOS-SSS-M achieved a Cronbach's α of 0.82-0.95. Confirmatory factor analysis revealed an acceptable fit index for the four-factor structure. Construct validity was demonstrated by significant association with self-reported HIV stigma and stress levels, and further confirmed by the findings of Rasch analysis. Conclusion: The MOS-SSS-M with a four-factor structure can be used to measure the level and categories of perceived social support among PLHIV in Myanmar.
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Affiliation(s)
- Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
- School of Nursing, University of California Los Angeles, Los Angeles, CA, United States
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, United States
| | - Sai Htun Lin
- Advocacy, Human Right, and Technical Services Department, Secretariat Office, Myanmar Positive Group (MPG), Yangon, Myanmar
| | - Min San Tun
- Advocacy, Human Right, and Technical Services Department, Secretariat Office, Myanmar Positive Group (MPG), Yangon, Myanmar
| | - Thet Wai Nwe
- National AIDS Program, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Yin Thet Nu Oo
- Health System Research Division, Department of Medical Research, Yangon, Myanmar
| | - Htun Nyunt Oo
- National AIDS Program, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
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20
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Wang X, Luo H, Yao E, Tang R, Dong W, Liu F, Liang J, Li H, Xiao M, Zhang Z, Niu J, Song L, Fu L, Li X, Qian S, Guo Q, Song Z. The role of personality, social economic and prevention strategy effects on health-related quality of life among people living with HIV/AIDS. Infect Dis Poverty 2021; 10:104. [PMID: 34344462 PMCID: PMC8336408 DOI: 10.1186/s40249-021-00890-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/20/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND HIV/AIDS has transformed into a chronic controllable but not yet curable infectious disease as other chronic diseases to some extent. The additional of so called fourth 90% that included the improved health-related quality of life (HRQoL) for people living with HIV (PLWHIV) required solutions beyond antiretroviral therapy and viral load suppression. This study will explore the role of personality, social economic and prevention strategy effection on HRQoL among people living with HIV/AIDS. METHODS A cross-sectional study was conducted among PLWHIV aged more than 16 years old in the 10 municipalities in Yunnan Province, China from October 2019 to May 2020, enrolling total 1997 participants. Individual-level HRQoL data were measured by 12-item Short Form Health Survey (SF-12) and EuroQol Five Dimensions Questionnaire (EQ-5D-5L). We assembled municipal-level data about social economic from Yunnan Statistical Yearbook in 2020 and strategy practice information from the self-evaluation system. We used the principal component analysis to build the social economic and strategy effect on each area respectively and one-way ANOVA was used to perform univariate analysis to identify the predictors with significant differences. Finally we used multi-level model (MLM) to explore the personality, social economic and strategy effects in health-related quality of life among PLWHIV. RESULTS The global score for quality of life measured using EQ-5D-5L had an estimated mean score (standard deviation, SD) of 0.901 ± 0.146. The HRQoL score measured using PCS-12 had an estimated mean score (SD) of 46.62 ± 8.55. The mean MCS-12 score (SD) was estimated to be 47.80 ± 9.71. The area-level predictors explained a proportion of 13.6-17.2% for the between-area variation of the HRQoL scores, regardless of the total HRQoL, physical component and mental component. The impacts of stigma (P < 0.01), social support (P < 0.001), anxiety (P < 0.001), depression (P < 0.05) and social economic status (P < 0.05) on HRQoL at the individual-level were significantly different. The plots visualized the impact of individual-level factors on a respondent's HRQoL was modified by the area-level characteristics. CONCLUSIONS The study identified the possible strategy determinant of individual HRQoL of PLWHIV and also the area effect on HRQoL. Stigma, social support, anxiety, depression and social economic status were the individual-level determinants on HRQoL. These could be a valuable resource for evaluating the overall health of the areas and help improve local decision making.
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Affiliation(s)
- Xiaowen Wang
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Hongbing Luo
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Enlong Yao
- Honghe Municipal Center for Disease Control and Prevention, Honghe, Yunnan Province China
| | - Renhai Tang
- Dehong Municipal Center for Disease Control and Prevention, Dehong, Yunnan Province China
| | - Wenbin Dong
- Yuxi Municipal Center for Disease Control and Prevention, Yuxi, Yunnan Province China
| | - Fuyong Liu
- Zhaotong Municipal Center for Disease Control and Prevention, Zhaotong, Yunnan Province China
| | - Jun Liang
- Kunming Municipal Center for Disease Control and Prevention, Kunming, Yunnan Province China
| | - Huilan Li
- Puer Municipal Center for Disease Control and Prevention, Puer, Yunnan Province China
| | - Minyang Xiao
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Zuyang Zhang
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Jin Niu
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Lijun Song
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Liru Fu
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Xuehua Li
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Shicong Qian
- Wenshan Municipal Center for Disease Control and Prevention, Wenshan, Yunnan Province China
| | - Qing Guo
- Lincang Municipal Center for Disease Control and Prevention, Lincang, Yunnan Province China
| | - Zhizhong Song
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
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21
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Ali S, Aquino-Adriatico G, Lewis-White R, Stoker C, Arms D, Grant C, Green-Sofola L. Multilevel factors associated with anxiety symptoms among people living with HIV in the US South. AIDS Care 2021; 34:805-811. [PMID: 34044721 DOI: 10.1080/09540121.2021.1924352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
People living with HIV are more likely than people not living with HIV to experience Generalized Anxiety Disorder (GAD) Symptoms. Scholars have found that 19%-23% of people living with HIV experience GAD Symptoms. Current studies overwhelmingly examine individual factors among national samples and are not conducted in the US South, where HIV rates have increased significantly in recent years. Even fewer studies examine the multilevel factors that are associated with anxiety in this US South. Thus, this study examined the multilevel factors associated with anxiety symptoms in a large US Southern City. A multivariate linear regression was conducted to examine multilevel factors associated with anxiety symptoms among 111 people living with HIV. Two structural variables, housing satisfaction and mental health service needs and one intrapersonal variable, health quality of life, were significantly associated with symptoms of anxiety. The study points to the needs of focusing multilevel interventions not only on housing conditions, but also attention to participants' satisfaction of their housing.
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Affiliation(s)
- Samira Ali
- Graduate College of Social Work, University of Houston, Houston, TX, USA
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22
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Valdelamar-Jiménez J, Lins-Kusterer L, de Jesus STG, Netto EM, Brites C. Comparison of Three Health-Related Quality of Life Instruments to Evaluate Symptoms of Depression in HIV Patients in Brazil. J Clin Psychol Med Settings 2021; 27:643-650. [PMID: 31456126 DOI: 10.1007/s10880-019-09657-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The evaluation of quality of life could be a useful indicator of depression in HIV patients. We compared the performance of three health-related quality of life (HRQoL) instruments for detecting depression. This nested case-control study included 200 HIV patients attended at an AIDS referral center. Depression was measured by Beck Depression Inventory (BDI). We accessed HRQoL by SF-36v2, HAT-QoL, and WHOQOL-HIV Bref. The depression diagnostic accuracy was evaluated by receiver operating characteristic (ROC) curve analysis. SF-36v2 presented negative correlation with BDI score (- 0.72 to - 0.40), and HAT-QoL (- 0.66 to 0.05) and WHOQoL-HIV Bref (- 0.67 to 0.32) domains presented negative and positive correlations. Mental Health (r = - .71) and Mental Component Summary (r = - .72) showed high negative correlation with BDI. SF-36v2 showed excellent measure by the ROC curve analysis in four factors, and high correlation in Mental Health and MCS. Sf-36 may represent a useful tool for screening of depressive symptoms in HIV patients.
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Affiliation(s)
- Juliet Valdelamar-Jiménez
- LAPI - Infectious Diseases Research Laboratory, Edgard Santos Federal University Hospital, Rua Augusto Viana, S/n, Canela, Salvador, Bahia, CEP-40110060, Brazil
| | - Liliane Lins-Kusterer
- LAPI - Infectious Diseases Research Laboratory, Edgard Santos Federal University Hospital, Rua Augusto Viana, S/n, Canela, Salvador, Bahia, CEP-40110060, Brazil.
| | | | - Eduardo Martins Netto
- LAPI - Infectious Diseases Research Laboratory, Edgard Santos Federal University Hospital, Rua Augusto Viana, S/n, Canela, Salvador, Bahia, CEP-40110060, Brazil
| | - Carlos Brites
- LAPI - Infectious Diseases Research Laboratory, Edgard Santos Federal University Hospital, Rua Augusto Viana, S/n, Canela, Salvador, Bahia, CEP-40110060, Brazil
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23
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Busi AN, Nsoh M, Otieno MO, Ndeso SA, Halle-Ekane GE. Evaluation of quality of life and associated factors among HIV patients on antiretroviral therapy in North West region of Cameroon. Afr Health Sci 2021; 21:8-17. [PMID: 34447418 PMCID: PMC8367311 DOI: 10.4314/ahs.v21i1.3s] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There is evidence that Quality of Life (QoL) of People Living with HIV/AIDS (PLHIV) has a significant role in ART retention, treatment adherence, and survival. As a result, QoL is becoming increasingly important for policymakers, program implementers, and researchers. However, factors associated with QoL, in a culturally diverse country like Cameroon are unknown. OBJECTIVE We aimed to assess the QoL of PLHIV on ART and assess the extent to which physical, psychosocial, environmental, and spiritual factors drive QoL. METHOD A cross-sectional study was conducted among 394 PLHIV aged >21 in North-West Cameroon from April to July 2019. Data were collected using WHO-QOL BREF questionnaire. Descriptive statistics, bivariate, and multivariate linear regression analyses were performed. RESULTS Majority (34.5%) of participants were in the age range of 41-50, with 73% females. The average QoL of the respondents was "good" with mean score of 3.57 on 5 and 71.4% agreed to have satisfactory QoL. Bivariate regression analyses revealed that all six proposed predictors were significantly associated with QoL. Psychological factors made the greatest impact (β = 0.213; p<0.003), followed by physical factors (β = 0.19; p<0.001). CONCLUSION PLHIV fairly agreed to have good QoL. The QoL was driven by mainly psychological and physical factors and not level of independence. However, the mean score perceptions for the investigated domains were low. Mental health services should consider these predictors when designing strategies to improve the QoL of PLHIV. While this study provides useful insights, other possible drivers of QoL among PLHIV should be investigated.
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Affiliation(s)
- Anissette N Busi
- Georgetown University Center for Global Health Practice and Impact; TIDE Project, Cameroon
| | - Marius Nsoh
- Department of Public Health, School of Health Sciences, Catholic University of Central Africa; Cameroon
| | - Moses O Otieno
- National AIDS and Sexually Transmitted Infections Control Program (NASCOP); Kenya
| | - Sylvester A Ndeso
- Department of Public Health, Faculty of Health Sciences, University of Buea; Cameroon
| | - Gregory E Halle-Ekane
- Department of Public Health, Faculty of Health Sciences, University of Buea; Cameroon
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Ayano G, Demelash S, Abraha M, Tsegay L. The prevalence of depression among adolescent with HIV/AIDS: a systematic review and meta-analysis. AIDS Res Ther 2021; 18:23. [PMID: 33906698 PMCID: PMC8077927 DOI: 10.1186/s12981-021-00351-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/19/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Depression is particularly common among adolescents with HIV/AIDS and has been associated with disruption of the important developmental process, subsequently leading to a wide range of negative mental, physical and psychosocial consequences, as well as poor quality of life in those population groups. Nevertheless, to the best of our knowledge, there are no prior systematic reviews and meta-analytic studies that determined the prevalence of depression among adolescents with HIV/AIDS. METHOD We systematically searched PubMed, Scopus and Web of Science for relevant literature until May 2020. A random-effect meta-analysis was used to pool prevalence rates from individual studies. Sensitivity and subgroup analyses were performed to identify the source of heterogeneities and to compare the prevalence estimates across the groups. The Joanna Briggs Institute's quality assessment checklist was used to evaluate the quality of the included studies. Cochran's Q and the I2 tests were used to assess heterogeneity between the studies. RESULTS A total of ten studies were included for the final analysis, with 2642 adolescents living with HIV/AIDS. Our final meta-analysis showed that more than a quarter of adolescents with HIV had depression [26.07% (95% CI 18.92-34.78)]. The prevalence was highest amongst female adolescents (32.15%) than males (25.07%) as well as amongst the older adolescents aged 15-19 years (37.09%) than younger adolescents aged 10-14 years (29.82%). CONCLUSION Our study shows that a significant proportion of adolescents with HIV had depression, indicating the imperativeness of intervention strategies to alleviate the suffering and possibly reduce the probable negative ramifications.
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25
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Santos WND, Silva RSD, Souza FMDLC, Santos RSDC, Oliveira ICD, Silva RARD. Ineffective health control: concept analysis. Rev Bras Enferm 2021; 74:e20190158. [PMID: 33787772 DOI: 10.1590/0034-7167-2019-0158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/05/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to identify and synthesize the concept of Ineffective Health Control. METHODS Concept Analysis from the perspective of Walker and Avant, operationalized by an integrative review in the databases Scopus, LILACS, PubMed, CINAHL, Web of Science, Science Direct e Cochrane, using the descriptors: Adhesion to Medication; Cooperation and Adherence to Treatment and Acquired Immunodeficiency Syndrome. RESULTS five critical attributes were identified for the concept, namely: patient's refusal to follow the therapeutic plan; abandoning treatment and worsening signs and symptoms; difficulty in reaching agreed goals; difficulty following health professionals' guidelines; multifactorial and dynamic process. CONCLUSIONS the concept of Ineffective Health Control is characterized by a multifactorial and dynamic process evidenced by the patient's refusal to follow a therapeutic plan, favouring the abandonment of treatment and resulting in the worsening of signs and symptoms and failure to reach goals.
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26
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Bagheri Z, Noorshargh P, Shahsavar Z, Jafari P. Assessing the measurement invariance of the 10-item Centre for Epidemiological Studies Depression Scale and Beck Anxiety Inventory questionnaires across people living with HIV/AIDS and healthy people. BMC Psychol 2021; 9:42. [PMID: 33750473 PMCID: PMC7941965 DOI: 10.1186/s40359-021-00546-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/02/2021] [Indexed: 12/03/2022] Open
Abstract
Background Recently, extensive research has been reported the higher rate of depression and anxiety among people living with HIV/AIDS (PLWHAs) as compared to the general population. However, no single study has been carried out to investigate whether this disparity is a real difference or it happens due to lack of measurement invariance. This study aims to assess the measurement invariance of the Beck Anxiety Inventory (BAI) and 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) questionnaires across PLWHAs and healthy individuals. Methods One hundred and fifty PLWHAs and 500 healthy individuals filled out the Persian version of the BAI and CESD-10 questionnaires. Multi-group multiple-indicators multiple-causes model (MG-MIMIC) was used to assess measurement invariance across PLWHAs and healthy people. Results Our findings revealed that PLWHAs and healthy individuals perceived the meaning of all the items in the BAI and CESD-10 questionnaires similarly. In addition, although depression scores were significantly higher in PLWHAs as opposed to the healthy individuals, no significant difference was observed in anxiety scores of these two groups. Conclusions The current study suggests that the BAI and CESD-10 are invariant measures across PLWHAs and healthy people which can be used for meaningful cross-group comparison. Therefore, in comparison to healthy individuals, higher depression score of PLWHAs is a real difference. It is highly recommended that health professionals develop therapeutic interventions and psychological supports to promote the mental health of PLWHAs which alleviate their depressive symptoms.
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Affiliation(s)
- Zahra Bagheri
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pegah Noorshargh
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Shahsavar
- Department of English Language, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Jafari
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Govender K, Durevall D, Cowden RG, Beckett S, Kharsany AB, Lewis L, George G, Cawood C, Khanyile D. Depression symptoms, HIV testing, linkage to ART, and viral suppression among women in a high HIV burden district in KwaZulu-Natal, South Africa: A cross-sectional household study. J Health Psychol 2020; 27:936-945. [PMID: 33382009 PMCID: PMC8855385 DOI: 10.1177/1359105320982042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Achieving the UNAIDS 90-90-90 targets by 2020 is contingent on identifying and
addressing mental health challenges that may affect HIV testing and
treatment-related behaviors. This study is based on survey data from
KwaZulu-Natal, South Africa (2014–2015). HIV positive women who reported higher
depression scores had a lower odds of having tested previously for HIV
(15–25 years: AOR = 0.90, 95% CI [0.83, 0.98]; 26–49 years: AOR = 0.90, 95% CI
[0.84, 0.96]). Because HIV testing behavior represents a gateway to treatment,
the findings suggest mental health may be one challenge to attaining the UNAIDS
90-90-90 targets.
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Affiliation(s)
| | | | | | | | | | - Lara Lewis
- University of KwaZulu-Natal, South Africa
| | | | - Cherie Cawood
- Epicentre AIDS Risk Management (Pty) Limited, South Africa
| | - David Khanyile
- Epicentre AIDS Risk Management (Pty) Limited, South Africa
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28
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Reddy AS, Tomita A, Paruk S. Depression, anxiety and treatment satisfaction in the parents of children on antiretroviral therapy in South Africa. PSYCHOL HEALTH MED 2020; 26:584-594. [PMID: 33085919 DOI: 10.1080/13548506.2020.1837389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Parents of children living with HIV are at increased risk of emotional distress, with negative implications for both their health outcomes. There is limited data on depression and anxiety symptoms in the biological parents as caregivers of children on antiretroviral therapy (ART) in South Africa. We investigated the prevalence and correlates associated with depressive and anxiety symptoms in 200 biological caregiving parents of children on ART at a public hospital in KwaZulu-Natal Province, South Africa. Data were obtained from the Patient Health Questionnaire (PHQ-9) for depressive symptoms and the Generalized Anxiety Depression (GAD-7) for anxiety symptoms, along with sociodemographic questionnaire. Most of the parent caregivers assessed were female (n = 190, 95%), younger than 40 years (n = 151, 75.5%), single (n = 173, 86.5%), unemployed (n = 156, 78%) and HIV+ (n = 183, 91.9%). Sixty-five (32.5%) parents screened positive for depression, 37 (18.5%) for anxiety and 31 (n = 31, 15.5%) for both disorders (i.e. depression/anxiety comorbidity). There were significant associations between death of a child to HIV (aOR = 4.66, 95% CI: 1.33-16.28) with depression/anxiety comorbidity as well as with treatment dissatisfaction (aOR = 13.98, CI: 2.09-93.66), but not with other socio-demographic factors. The high prevalence of depression and anxiety amongst the parent caregivers of children living with HIV suggests the need for mental health screening and care among parents of children attending pediatric HIV services, and particularly for those with history of children lost to HIV.
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Affiliation(s)
- Aderlee S Reddy
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Tomita
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,Centre for Rural Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Maleki MR, Derakhshani N, Azami-Aghdash S, Naderi M, Nikoomanesh M. Quality of Life of People with HIV/AIDS in Iran: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1399-1410. [PMID: 33083316 PMCID: PMC7554383 DOI: 10.18502/ijph.v49i8.3861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Assessing the quality of life in HIV/AIDS patients is of great importance not only for evaluating the effect of the disease, but also to measure the impact of the interventions in order to improve their quality of life in clinical researches. Therefore, this study aimed to systematically review the quality of life of HIV/AIDS patients in Iran. Methods: In this systematic review and meta-analysis, the literature search using the related chain of keywords was conducted from 1 Jan 1987 to 30 Apr 2019 in PubMed, Scopus, Web of Science, Embase, Iranian Scientific Information Database (SID), and Magiran. Moreover, hand search of the key journals and the gray literature was performed. The meta-analysis was performed by CMA2 software. Results: Out of the 1576 retrieved records, eight studies met the inclusion criteria. The average age of the patients was 37.15 ± 9.46 years. The average score of quality of life before and after sensitivity analysis was (39.13 [28.36–49.901 95% CI P>0.000] vs. 49.05 [46.31–51.79 95% CI P>0.000]). Moreover, the average score of quality of life was respectively 38.86±3.83 vs. 40±6.37 among married compared with single patients, 56.33±4.67 vs. 43.64±1.94 for employment vs. unemployment status. While quality of life was measured in terms of education level, the score was 29.59±9.34 vs. 41.65±4.45 in the individuals with primary school versus academic education. Conclusion: The QOL score of the HIV/AIDS patients in Iran was significantly low. Therefore, the study highlights the importance of strengthening efforts to undertake necessary investigations in order to provide adequate health insurance, extensive and affordable welfare services, and more appropriate social and mental supports in order to improve the quality of life of the individuals with HIV/AIDS in Iran.
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Affiliation(s)
- Mohammad Reza Maleki
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Naser Derakhshani
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehran Naderi
- Department of Food Science and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Nikoomanesh
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
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30
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Onu DU, Ifeagwazi CM, Chukwuorji JC. Does Posttraumatic Growth Buffer the Association Between Death Anxiety and Quality of Life Among People living with HIV/AIDS? J Clin Psychol Med Settings 2020; 28:229-238. [PMID: 32086637 DOI: 10.1007/s10880-020-09708-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
People living with HIV (PLWH) may experience death anxiety (DA), which can be detrimental to quality of life. Posttraumatic growth (PTG), however, is antithetical to DA, with its positive attributes at odds with negative psychosocial outcomes. Previous research has not examined the buffering effect of PTG on the association between DA and quality of life. Therefore, in addition to the direct effects of DA and PTG on health-related quality of life (HRQoL), we investigated the moderating role of PTG on the relationship between DA and HRQoL among people living with HIV/AIDS (PLWH) in Nigeria. Using cross-sectional design and availability sampling method, we selected 201 outpatients (men, n = 63, 31.3%, women, n = 138, 68.7%, mean age = 40.1, SD = 10.5) managed for HIV/AIDS in a Nigerian tertiary healthcare institution. Death Anxiety Inventory-Revised, Posttraumatic Growth Inventory-Short Form, and Patient-Reported Outcome Quality of Life-HIV were used to access DA, PTG and HRQoL, respectively. Results showed that while adjusting for socio-demographic factors (age, gender, time since diagnosis and educational status), DA was associated with physical health, mental health and social relationships domains of HRQoL as well as overall HRQoL. In contrast, PTG did not evidence significant association with HRQoL dimensions and overall HRQoL. The moderation effect of PTG on the association between DA and HRQoL was not supported. Independent of PTG, alleviating DA may be an important target in terms of therapeutic intervention towards improving quality life of PLWH.
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Affiliation(s)
| | - Chuka Mike Ifeagwazi
- Department of Psychology, University of Nigeria, Nsukka, 41000, Enugu State, Nigeria
| | - JohnBosco Chika Chukwuorji
- Department of Psychology, University of Nigeria, Nsukka, 41000, Enugu State, Nigeria. .,Department of Psychology, College of Sciences and the Health Professions, Cleveland State University, Cleveland, OH, 44115, USA.
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Rezaei S, Ahmadi S, Rahmati J, Hosseinifard H, Dehnad A, Aryankhesal A, Shabaninejad H, Ghasemyani S, Alihosseini S, Bragazzi NL, Raoofi S, Kiaee ZM, Ghashghaee A. Global prevalence of depression in HIV/AIDS: a systematic review and meta-analysis. BMJ Support Palliat Care 2019; 9:404-412. [PMID: 31537580 DOI: 10.1136/bmjspcare-2019-001952] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/19/2019] [Accepted: 09/04/2019] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The incidence of some fatal diseases, including HIV/AIDS, accompanied by depression has become a significant concern in developed, developing and underdeveloped countries. A great deal of time and money are spent on controlling and reducing the complications of this infection across the world. Accordingly, the main purpose of this study was to clarify the global prevalence rate of depression in patients living with HIV/AIDS via a systematic review and meta-analysis. METHODOLOGY All articles in English, published between 2000 and 2018, were systematically searched from the original databases of Web of Science, PubMed, Scopus, Cochrane Library, Google Scholar and Embase. As a result, a total of 118 articles were identified. RESULTS The total sample size in these articles was 51143 people, and the number of patients suffering from moderate and severe levels of depression was 14 942. The results of the analysis based on the random-effects (DerSimonian and Laird) model revealed that the prevalence rate of depression in patients with HIV/AIDS was 31% (95% CI 28% to 34%), with a 98% heterogeneity index which was reported significant. Meanwhile, the highest prevalence rate of depression based on continent was in South America at 44% (95% CI 35% to 53%) and the lowest rate was in Europe at 22% (95% CI 17% to 27%). CONCLUSION In general, there was a higher prevalence rate of depression in developing and underdeveloped countries than in developed countries, which could be attributed to the advancement of science and the possibilities for early diagnosis of this syndrome. TRIAL REGISTRATION NUMBER CRD42019119137.
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Affiliation(s)
- Sepide Rezaei
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saba Ahmadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Jeiran Rahmati
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Hosseinifard
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Afsaneh Dehnad
- Department of Foreign Languages, Faculty of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran
| | - Aidin Aryankhesal
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.,Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hosein Shabaninejad
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
| | - Shabnam Ghasemyani
- Student Research Committee, Faculty of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Samira Alihosseini
- Department of Health Management, Policy and Economics, Kerman University of Medical Sciences, Kerman, Iran
| | - Nicola Luigi Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Samira Raoofi
- Student Research Committee, Faculty of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Mansour Kiaee
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
| | - Ahmad Ghashghaee
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran .,Student Research Committee, Faculty of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran
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Souza HCD, Mota MR, Alves AR, Lima FD, Chaves SN, Dantas RAE, Abdelmur SBM, Mota APVDS. Analysis of compliance to antiretroviral treatment among patients with HIV/AIDS. Rev Bras Enferm 2019; 72:1295-1303. [PMID: 31531654 DOI: 10.1590/0034-7167-2018-0115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 10/13/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the compliance to antiretroviral therapy among HIV/AIDS patients. METHOD 99 HIV-positive volunteers undergoing treatment responded to a semi-structured sociodemographic interview and to a questionnaire that assessed compliance to antiretroviral treatment. RESULTS In the sample analyzed, 52.5% of the volunteers presented good/adequate treatment compliance, while 33.3% presented low/insufficient compliance. There was no significant difference between men and women in the questionnaire score, nor between groups with different levels of education. CONCLUSION The main items of the questionnaire that contributed to good/adequate compliance were: positive impact of treatment on health and quality of life, few side effects after initiation of therapy, and positive self-evaluation of participants regarding their compliance to antiretroviral therapy. The main barriers detected for compliance to antiretroviral therapy were the lack of knowledge about current medications and the lack of information on antiretroviral therapy drugs.
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Affiliation(s)
| | - Márcio Rabelo Mota
- Centro Universitário de Brasília. Brasília, Distrito Federal, Brazil.,Centro Universitário de Anápolis. Anápolis, Goiás, Brazil
| | | | | | | | - Renata Aparecida Elias Dantas
- Centro Universitário de Brasília. Brasília, Distrito Federal, Brazil.,Centro Universitário de Anápolis. Anápolis, Goiás, Brazil
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Patrício ACFDA, Silva IBDN, Ferreira MAM, Rodrigues BFL, Silva RFD, Nascimento JAD, Silva RARD. Depression, self-concept, future expectations and hope of people with HIV. Rev Bras Enferm 2019; 72:1288-1294. [PMID: 31531653 DOI: 10.1590/0034-7167-2018-0730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 10/10/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze conditions of depression, self-concept, future expectations and hope in people with HIV/AIDS. METHOD Cross-sectional survey of 108 individuals living with HIV/AIDS, carried out in a reference hospital for the treatment of infectious diseases in Northeast Brazil. The following instruments were employed: sociodemographic data, and questionnaires for ascertaining participants' emotions, including scales for self-concept, hope, depression (HAMD-D), and future expectations. Descriptive statistics using the following tests were performed: Mann-Whitney, Kruskal-Wallis, chi-square, and t-test-considered significant when p ≤ 0.05. RESULTS 31.5% presented mild depression and 21.3% presented moderate depression; 63% reported difficulty in obtaining decent employment; 52.8% considered life a failure; 52.8% felt worthless. Fear, guilt and loneliness influenced self-concept (p ≤ 0.05). Loneliness influenced hope (p ≤ 0.05). CONCLUSION It is necessary to raise the attention of nursing professionals and healthcare managers to the importance of providing health services that consider the mental health of people with HIV/AIDS, contributing to treatment adherence and well-being.
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Lins-Kusterer L, Valdelamar J, Aguiar CVN, Menezes MS, Netto EM, Brites C. Validity and reliability of the 36-Item Short Form Health Survey questionnaire version 2 among people living with HIV in Brazil. Braz J Infect Dis 2019; 23:313-321. [PMID: 31491370 PMCID: PMC9427962 DOI: 10.1016/j.bjid.2019.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 07/29/2019] [Accepted: 08/07/2019] [Indexed: 01/08/2023] Open
Abstract
Background The 36-Item Short Form Health Survey questionnaire (SF-36) is a widely used instrument for evaluating health-related quality-of-life (HRQoL). The psychometric validation of the SF-36 version 2.0 (SF-36v2) in HIV-infected patients had not yet conducted in Brazil. Aim To test data quality, reliability and validity of the SF-36v2 as a measure of HRQoL among Brazilian individuals living with HIV. Methods A cross-sectional study included 393 HIV-infected patients in whom HRQoL was assessed by using the SF-36v2 questionnaire. Demographic characteristics, socioeconomic status and clinical data were also collected. The SF-36 version 1 translated into Brazilian-Portuguese was adapted and introduced version 2 improvements according to the instrument developers. SPSS version 21 was used for data analyses. Confirmatory factor analysis (CFA) and structural equation modelling were performed using AMOS SPSS version 18. T-test for independent samples was used to compare differences between mean levels of HRQoL components in different groups. Linear multiple regression techniques were used to analyze the relationship between Physical Component Summary (PCS), Mental Component Summary (MCS) and independent variables. Results We performed the CFA and tested the hypothetical measurement model. We included five parameters to improve the adherence of data to the model. All indicators met the requirement suggested by specialized literature (χ2 (gl): 980.7 (527); CFI: 0.949; GFI: 0.873; TLI: 0.943; RMSEA: 0.047; 90% IC: 0.042-0.051). Multiple regression analyses revealed that depression (p = 0.001), family income (p = 0.007), sex (p = 0.001) and age (p< 0.021) were associated with MCS. Comorbidities (p = 0.001), health self-perception (p = 0.001), age (p = 0.001), and sex (p = 0.025) were associated with PCS. Conclusions A consistent validation of the SF-36v2 in Brazilian HIV patients were shown. Further studies with SF-36v2 psychometric analyses would be required in other populations to establish Brazilian normative data.
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Affiliation(s)
- Liliane Lins-Kusterer
- Hospital Universitário Professor Edgard Santos, Laboratório de Pesquisa em Doenças Infecciosas, Salvador, BA, Brazil.
| | - Juliet Valdelamar
- Hospital Universitário Professor Edgard Santos, Laboratório de Pesquisa em Doenças Infecciosas, Salvador, BA, Brazil
| | | | | | - Eduardo Martins Netto
- Hospital Universitário Professor Edgard Santos, Laboratório de Pesquisa em Doenças Infecciosas, Salvador, BA, Brazil
| | - Carlos Brites
- Hospital Universitário Professor Edgard Santos, Laboratório de Pesquisa em Doenças Infecciosas, Salvador, BA, Brazil
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Agus DF, Effendy E, Camellia V. Screening of Anxiety and Depression Related CD4 Count of People Living with HIV/AIDS with Anti-Retroviral in Medan, Indonesia. Open Access Maced J Med Sci 2019; 7:2590-2594. [PMID: 31777611 PMCID: PMC6876798 DOI: 10.3889/oamjms.2019.396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/13/2019] [Accepted: 07/14/2019] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND HIV, which causes AIDS, infects the immune system cells, by destroying or damaging the function of the CD4. PLWHA will have twice the risk of experiencing mental health disorders such as depression and anxiety compared with the general population, thereby suppressing immune function, decreasing their quality of life, decreasing the level of adherence to treatment, and contributing significantly to the occurrence of premature death. AIM To determine the correlation Anxiety and Depression symptoms and CD4 levels in PLWHA who are undergoing Anti-Retroviral treatment at the HIV/AIDS. METHODS The study was a cross-sectional study, which assesses the correlation between Hospital Anxiety and Depression Scale scores (HADS) and CD4 levels in PLWHA who are receiving ARV in the HIV/AIDS Special Services Polyclinic Medan Haji general hospital. RESULTS It was found that the average HADS-A score, PLWHA was 15.286 and the SD ± 2.244. This shows that PLWHA is in moderate to severe anxiety and moderate to severe depression. The mean CD4 level of people with HIV/AIDS/PLWHA was 288.171 and SD ± 88.955. According to WHO criteria, regarding the classification of HIV immunodeficiency in adults, are classified as moderate immunodeficiency. There was a significant correlation between the HADS-A score and CD4 level with a correlation value of r = -0.592 indicating a negative correlation with a moderate correlation strength, and the correlation between HADS-D score and CD4 level. The strength of the relationship between HADS-D score and CD4 level is r = -0.650, shows a negative correlation with strong correlation strength. CONCLUSION from this study, it was found that there is a relationship between depression and anxiety symptom and CD4 level.
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Affiliation(s)
- Dona Farila Agus
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Elmeida Effendy
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Vita Camellia
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Andini S, Yona S, Waluyo A. Self-efficacy, depression, and adherence to antiretroviral therapy (ART) among Indonesian women with HIV. ENFERMERIA CLINICA 2019. [PMID: 31302024 DOI: 10.1016/j.enfcli.2019.04.105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed at investigating the relationship between self-efficacy, depression, and adherence to antiretroviral therapy (ART) in Indonesian women with HIV. METHOD This study employed a cross-sectional research design. The participants were 120 women with HIV aged 18-60 years on self-administered ART regimens. RESULTS This study shows a significant relationship between self-efficacy and adherence to ART (p-value=0.004; OR 2.330). Women are living with HIV with high self-efficacy adherence to following their ART 2.33 times more often than those with low self-efficacy. It is shown that a significant relationship exists between depression and adherence to ART (p-value=0.001; OR 3.647). Depressed HIV women took ART medication 3.64 times less often than who did not have depression. CONCLUSION It is recommended to increase the level adherence rate by improving self-efficacy and reduce depression.
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Affiliation(s)
- Sandra Andini
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia; Dr. H. Abdul Moeleok Hospital, Lampung, Bandar Lampung, Indonesia
| | - Sri Yona
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia.
| | - Agung Waluyo
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
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Sehgal HS, Kohli R, Pham E, Beck GE, Anderson JR. Tooth wear in patients treated with HIV anti-retroviral therapy. BMC Oral Health 2019; 19:129. [PMID: 31242887 PMCID: PMC6595590 DOI: 10.1186/s12903-019-0818-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 06/07/2019] [Indexed: 11/17/2022] Open
Abstract
Background The objective of this study was to elucidate the relationship between HIV anti-retroviral therapy and tooth wear. Methods Assessment of tooth wear was conducted both with a survey questionnaire and clinical assessment at Russell Street Dental Clinic in Portland, Oregon. The survey questionnaire comprised of questions on study participant’s gender, age, HIV status, current medications, awareness of tooth grinding or clenching, jaw soreness, tooth or gum soreness, and frequency of headaches. For the clinical evaluation, a dental provider recorded the degree of wear on each tooth using a scale of 0–3. An individual tooth-wear index was used to rank patients with regard to incisal and occlusal wear. Data analysis included descriptive analysis, tests of association and regression analysis using SPSS V.24. Results The study sample involved 93 patients (HIV + ve = 60, HIV–ve = 33) with age range of 20-90 yrs. (mean = 49 yrs., s.d = 13.3). 92 and 67% participants of the HIV + ve and HIV-ve groups, respectively, presented with tooth wear. The mean tooth wear index was higher in HIV + ve patients than HIV–ve patients (8.2 vs. 7.8), however, this difference was not statistically significant (p > 0.05). A significant, positive correlation was found between HIV presence and tooth wear index, after accounting for age (B = 0.71, p < 0.05). The number of years on anti-retroviral therapy alone was positively correlated with tooth wear index (R2 = 0.116, p < 0.05). After controlling for age, years of anti-retroviral therapy use was positively correlated with tooth wear index (B = 0.047, p > 0.05). Conclusions The findings from this study suggest that HIV + ve patients, who are on anti-retroviral therapy have significant tooth wear, although more studies with larger sample size are needed to confirm this. There is a critical need to initiate a dialogue with medical providers about tooth wear as a possible side effect of antiretroviral therapy and to introduce appropriate preventive measures.
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Affiliation(s)
- Harjit Singh Sehgal
- Department of Periodontology, School of Dentistry, Oregon Health & Science University, 5N034 SDPERI, 2730 SW Moody Ave, Portland, Oregon, 97201-5042, USA.
| | - Richie Kohli
- Department of Community Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Edward Pham
- School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Grace E Beck
- Department of Endodontics, The University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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Been SK, Schadé A, Bassant N, Kastelijns M, Pogány K, Verbon A. Anxiety, depression and treatment adherence among HIV-infected migrants. AIDS Care 2019; 31:979-987. [PMID: 30957530 DOI: 10.1080/09540121.2019.1601676] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Diagnosing symptoms of psychological distress can be challenging in migrants living with HIV (MLWH) living in Western Europe. We evaluated the Hospital Anxiety and Depression Scale (HADS) as a screening tool for psychological distress. Additionally, the association between psychological distress and adherence to combination Antiretroviral Therapy (cART) was determined. Socio-demographic and clinical characteristics, psychosocial variables, and self-reported adherence to cART data were collected. 306/352 participants completed the HADS. A HADS+ (≥15, at risk for psychological distress) was found in 106/306. The Composite International Diagnostic Interview (CIDI) was completed by 60/106. The HADS was repeated in 58 participants as the time between the first HADS and the CIDI was more than three months. In 21/37 participants with a HADS+ (57%) within three months before the CIDI a diagnosis of depression or anxiety disorder based on the CIDI was found. Participants with a HADS+ were more likely to be non-adherent (71.3% vs. 43.6%). In a large group of MLWH in the Netherlands, 35% were at risk for symptoms of psychological distress. The HADS seems to be a suitable screening tool for MLWH.
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Affiliation(s)
- S K Been
- a Department of Internal Medicine, Division of Infectious Diseases , Erasmus University Medical Center Rotterdam , Netherlands
| | - A Schadé
- b Department of Psychiatry , Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam , Netherlands
| | - N Bassant
- a Department of Internal Medicine, Division of Infectious Diseases , Erasmus University Medical Center Rotterdam , Netherlands
| | - M Kastelijns
- c Department of Internal Medicine , Maasstad Hospital , Rotterdam , Netherlands
| | - K Pogány
- c Department of Internal Medicine , Maasstad Hospital , Rotterdam , Netherlands
| | - A Verbon
- d Department of Medical Microbiology and Infectious Diseases , Erasmus University Medical Center , Rotterdam , Netherlands
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Abstract
: Neurological conditions associated with HIV remain major contributors to morbidity and mortality and are increasingly recognized in the aging population on long-standing combination antiretroviral therapy (cART). Importantly, growing evidence shows that the central nervous system (CNS) may serve as a reservoir for viral replication, which has major implications for HIV eradication strategies. Although there has been major progress in the last decade in our understanding of the pathogenesis, burden, and impact of neurological conditions associated with HIV infection, significant scientific gaps remain. In many resource-limited settings, antiretrovirals considered second or third line in the United States, which carry substantial neurotoxicity, remain mainstays of treatment, and patients continue to present with severe immunosuppression and CNS opportunistic infections. Despite this, increased global access to cART has coincided with an aging HIV-positive population with cognitive sequelae, cerebrovascular disease, and peripheral neuropathy. Further neurological research in low-income and middle-income countries (LMICs) is needed to address the burden of neurological complications in HIV-positive patients, particularly regarding CNS viral reservoirs and their effects on eradication.
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Shi Y, Zhao M, Chen S, Wang S, Li H, Ying J, Zhang M, Li Y, Xing Z, Sun J. Effects of cognitive behavioral therapy on people living with HIV and depression: A systematic review and meta-analysis. PSYCHOL HEALTH MED 2018; 24:578-594. [PMID: 30479159 DOI: 10.1080/13548506.2018.1549739] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The aim of this review is to examine the efficacy of cognitive behavioral therapy (CBT) on people living with HIV (PLWH) and depression. A literature search from five electronic databases was conducted, and articles published until July 2017 were collected. The inclusion criteria included randomized controlled trials (RCTs) of CBT that were conducted among PLWH with clinically relevant depression. Comprehensive Meta-Analysis 2 was used to obtain pooled results. Seven RCTs, with a total sample size of 388 participants, met the inclusion criteria. Compared with the control group, the CBT group had statistically significant, short-term improvements in depression (g = -0.486, 95% CI [-0.969 to -0.003], P = 0.048). A significant reduction in viral load was also observed at the long-term follow-up (g = -0.306, 95% CI [-0.573 to -0.040], P = 0.024), but no improvements were found in CD4. Results of this meta-analysis showed that CBT is effective in reducing depression symptoms in PLWH with comorbid depression for a short period of time. However, the findings of this review may not be generalized in the clinical field due to the small number of involved studies and the limited study sample. Thus, more robust and adequately powered studies are needed to further explore CBT interventions in PLWH with depression.
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Affiliation(s)
- Ying Shi
- a School of Nursing , Jilin University , Changchun , People's Republic of China.,b School of Nursing , Hubei University of Medicine , Shiyan , People's Republic of China
| | - Minghui Zhao
- c Department of Endocrinology , The Second Hospital of Jilin University , Changchun , People's Republic of China
| | - Si Chen
- d The First Bethune Hospital of Jilin University , Changchun , People's Republic of China
| | - Shouqi Wang
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Huanhuan Li
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Jie Ying
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Meiling Zhang
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Yuan Li
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Zhuangjie Xing
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Jiao Sun
- a School of Nursing , Jilin University , Changchun , People's Republic of China
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Makhathini KB, Mabandla MV, Daniels WMU. Rosmarinic acid reverses the deleterious effects of repetitive stress and tat protein. Behav Brain Res 2018; 353:203-209. [PMID: 30029998 DOI: 10.1016/j.bbr.2018.07.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 06/29/2018] [Accepted: 07/17/2018] [Indexed: 12/27/2022]
Abstract
Human immunodeficiency virus type 1 (HIV) has infected more than 40 million people worldwide and is associated with central nervous system (CNS) disruption in at least 30% of these persons. The use of highly active antiretroviral therapy (HAART) has significantly reduced the systemic immunopathology associated with HIV, but the occurrence of neurological disorders continues to be reported in notable numbers. The present study evaluated the potential of rosmarinic acid to reverse the detrimental effects of an intracerebral injection of the viral protein tat. Control and tat-injected rats were also subjected to repetitive restrain stress (RRS) for 28 days, 6 h per day, to investigate whether subsequent stress exposure would worsen the effects of tat. 14 days after the initiation of RRS, animals were treated with rosmarinic acid (10 mg/kg given intraperitoneally) daily until the end of the stress exposure period. We assessed locomotor activity and anxiety-like behavioral changes. We also measured plasma corticosterone levels and quantified the expression of mineralocorticoid receptors (MR), glucocorticoid receptors (GR) and brain-derived neurotrophic factor (BDNF) in the hippocampus. Rosmarinic acid attenuated anxiety-like behavior induced by tat and stress, reduced plasma corticosterone levels and increased the expression of hippocampal GR, MR and BDNF when compared to controls. These results suggest that rosmarinic acid may reverse the anxiogenic effect of HIV-1 viral protein tat and related stress through modulation of the hypothalamic-pituitary-adrenal axis and hippocampal neurotrophic factor levels.
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Affiliation(s)
- Khayelihle B Makhathini
- School of Laboratory Medicine and Medical Science, College of Health Science, University of KwaZulu-Natal, Durban, 4000, South Africa.
| | - Musa V Mabandla
- School of Laboratory Medicine and Medical Science, College of Health Science, University of KwaZulu-Natal, Durban, 4000, South Africa
| | - William M U Daniels
- School of Phyisiology, University of the Witwatersrand, Johannesburg, South Africa
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Lédo AP, Rodriguez-Prieto I, Lins L, Neto MG, Brites C. Association Between Health-Related Quality of Life and Physical Functioning in Antiretroviral-Naive HIV-Infected Patients. Open AIDS J 2018; 12:117-125. [PMID: 30369996 PMCID: PMC6182873 DOI: 10.2174/1874613601812010117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 08/24/2018] [Accepted: 09/06/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Poor functional status can significantly affect Health-Related Quality of Life (HRQoL) of HIV patients. However, there is scarce information on the functional profile of such patients before starting antiretroviral therapy (ART). Objective: To estimate the association between health-related quality of life and physical functioning in Antiretroviral-Naive HIV-infected patients. Methods: We conducted a cross-sectional study with HIV-infected patients older than 18 years, and naïve to antiretroviral therapy. The patients were evaluated for functional profile by pulmonary function (forced vital capacity, forced expiratory volume at one second, and Tiffeneau index), handgrip strength, and six-minute walk test in a cross-sectional study. HRQoL was evaluated by the 36-Item Short-Form Health Survey and its Physical (PCS) and Mental (MCS) Component Summaries. Multiple linear regression analyses were used to evaluate the association of predictor variables with PCS and MCS scores. Results: We found lower HRQoL among females patients, with far below average impairment of mental health component. Both male and female patients presented lower 6MWD function test values. Patients with dynapenia were older than patients without it, presented lower PCS mean score, lower family income, poor 6 MWD function test, lower FVC, and lower FEV1 t. Multivariable logistic regression analyses showed that Grip Strength, age and family income were predictor variables for Physical component of HRQoL. Female gender and smoking habit were predictive for the mental component of HRQoL. Conclusion: HRQoL in HIV, drug-naïve patients is predicted by level of dynapenia, smoking, income and gender. Therefore, lifestyle changes and active exercising can help to improve HRQoL in such patients.
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Affiliation(s)
- Ana Paula Lédo
- School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Liliane Lins
- School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Carlos Brites
- Research Laboratory of Infectious Diseases, Edgard Santos Federal University Hospital, Salvador, Bahia, Brazil
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da Costa Vieira V, Lins L, Sarmento VA, Netto EM, Brites C. Oral health and health-related quality of life in HIV patients. BMC Oral Health 2018; 18:151. [PMID: 30157834 PMCID: PMC6116554 DOI: 10.1186/s12903-018-0605-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/08/2018] [Indexed: 12/12/2022] Open
Abstract
Background Oral health care may improve the health-related quality of life (HRQoL) of HIV/AIDS patients. We aimed to evaluate oral health and HRQoL of HIV/AIDS patients using antiretroviral therapy. Methods A cross-sectional study included 120 HIV-infected patients, aged ≥18 years, from February, 2016 to September, 2017. The 36-Item Short Form Health Survey (SF-36) was used to evaluate the HRQoL. We assessed dental caries status using the Decayed, Missing and Filled Teeth (DMFT) index. Information about demographic, socioeconomic status, depression, and other comorbidities were collected. All patients with depression had a medical diagnosis. Comorbidities were defined as medical diagnoses of arterial hypertension, type-2 diabetes, tuberculosis, syphilis, cardiopathy, chronic renal failure, lymphoma, HCV infection, HBV infection and fatty liver disease. Independent t-tests were used to compare differences between mean levels of HRQoL, age, and DMFT and its components according to groups of sex, comorbidities and depression. Simple linear regression was used to analyze the relationship between the Mental Component Summary (MCS) and DMFT, and a multiple regression equation investigated depression, age, MCS, and comorbidities as predictors of DMFT. Results The mean DMFT index was 12.4 ± 8.2. A linear regression equation estimated a significant (p = 0.022) decrease of 0.25 unit (%) in MCS for each unit increase in DMFT. Among depressed patients, a significant (p = 0.008) decrease of 0.67% in MCS for each unity increase in DMFT was estimated. Depressed patients showed worse oral health indicators (DFMT index; p ≤ 0.001; and mean Missing Teeth; p ≤ 0.052) and lower HRQoL domains than non-depressed patients. DMFT remained associated with depression (P < 0.005) after controlling for age, MCS, and comorbidities. Conclusions We found association between poorer oral health (higher DMFT index) and lower Mental Health Component Summary in HIV-infected patients with depression. Patients with depression deserve especial attention to their HRQoL and oral care.
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Affiliation(s)
- Vinicius da Costa Vieira
- School of Medicine, Federal University of Bahia, Praça XV de Novembro, Largo do Terreiro de Jesus s/n, Salvador, Bahia, CEP 400260-10, Brazil
| | - Liliane Lins
- School of Medicine, Federal University of Bahia, Praça XV de Novembro, Largo do Terreiro de Jesus s/n, Salvador, Bahia, CEP 400260-10, Brazil.
| | | | - Eduardo Martins Netto
- Research Laboratory of Infectious Diseases, Edgard Santos Federal University Hospital, Salvador, Bahia, Brazil
| | - Carlos Brites
- Research Laboratory of Infectious Diseases, Edgard Santos Federal University Hospital, Salvador, Bahia, Brazil
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Gebremichael DY, Hadush KT, Kebede EM, Zegeye RT. Gender difference in health related quality of life and associated factors among people living with HIV/AIDS attending anti-retroviral therapy at public health facilities, western Ethiopia: comparative cross sectional study. BMC Public Health 2018; 18:537. [PMID: 29688853 PMCID: PMC5913892 DOI: 10.1186/s12889-018-5474-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 04/17/2018] [Indexed: 11/10/2022] Open
Abstract
Background Though HIV/AIDS has multidimensional consequences on quality of life, there is a gap in measuring and monitoring health related quality of life of HIV/AIDS patients. Hence, this study intended to measure health related quality of life domains and associated determinants among people living with HIV/AIDS in western Ethiopia. Methods A comparative cross-sectional study was conducted among 520 HIV/AIDS patients on anti-retroviral therapy in public health facilities in West Shoa Zone, Western Ethiopia from April to May, 2016. Participants were selected using simple random sampling method. Quality of life was measured using WHOQOL-HIV BREF and depression was assessed using Beck Depression Inventory, Second Edition (BDI-II). Data were analyzed using SPSS version 22. An independent sample t-test was used to compare quality of life domains between men and women and logistic regression analysis was used to determine independent predictors. Results Females had significantly lower quality of life in physical, psychological, independence and environmental domains as compared with males except social relationship and spiritual domains. Depressed HIV patients had significantly lower quality of life in all domains as compared with HIV infected patients without depression in both genders. Malnutrition and anemia were significantly associated with poor physical, psychological, independence and environmental domains. Anemic women had 1.9 times lower independence quality of life compared with women who had no anemia (AOR = 1.9, 95%CI: 1.4, 3.5). Tuberculosis was also predictor of physical, psychological, independence and social domains in both genders. TB/HIV co-infected females had 2.0 times poorer environmental health compared to only HIV infected females (AOR = 2.0, 95%CI: 1.2, 3.5). Family support, education and occupation were also independent significant predictors of QOL domains in both genders. In females, residence was significantly associated with independence (AOR = 1.8, 95%CI: 1.2–3.8) and environmental (AOR = 1.5, 95%CI: 1.1–3.2) domains. Conclusions Females had significantly lower quality of life compared with males. The findings indicted poor socio-economic status and co-infections significantly associated with poor quality of life among HIV/AIDS patients. So, due emphasis should be given to improve socio-economic status and enhance integrated early detection and management of malnutrition, depression, tuberculosis and anemia among HIV/AIDS patients in Ethiopia.
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Affiliation(s)
- Delelegn Yilma Gebremichael
- College of medicine and health sciences, Department of Public Health, Ambo University, P.O. Box 19, Ambo, Ethiopia.
| | - Kokeb Tesfamariam Hadush
- College of medicine and health sciences, Department of Public Health, Ambo University, P.O. Box 19, Ambo, Ethiopia
| | - Ermiyas Mulu Kebede
- College of medicine and health sciences, Department of Public Health, Ambo University, P.O. Box 19, Ambo, Ethiopia
| | - Robel Tezera Zegeye
- College of medicine and health sciences, Department of Public Health, Ambo University, P.O. Box 19, Ambo, Ethiopia
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